Clinical prediction of antidepressant response

Depression is not a unitary disease and not all cases of depression can be treated alike. Therefore, predictors of antidepressant response to different drugs need to be identified. Premorbid personality, age and sex and family history are useful in prediction. As an example, only females respond to the addition of triiodothyronine to the antidepressant therapy. Endogenous depressions respond favourably to antidepressants, so also do psychotic depressions. On the other hand, delusional depressions do not respond to antidepressants. While atypical depressions are best treated with MAOI, motor retardation improves with imipramine and obsessive symptoms with chlorimipramine. In addition to clinical variables, biochemical and statistical approaches have also yielded significant results in prediction.